<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>住院信息更改</title>

<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta name="keywords" content="短照中心-湘潭市康复养老中心;">
<meta name="description" content="短照中心-湘潭市康复养老中心;">
<link rel="stylesheet" rev="stylesheet" href="css/framepage.css" type="text/css" media="screen" />
</head>

<body style="background:rbg(216,216,216);">
<div class="form_div">
<h3>变更住院信息 科室：长照中心康复中心大楼13楼</h3>
  <form>
       <ul>
       <li style="width:100%">
          <span class="tit" style="width:70px;">选择长者：</span>
            <select name="keshi" style="position:absolute;left:90px;top:0;width:197px;">
            <option value="">12楼</option>
			<option value="">13楼</option>
			<option value="">14楼</option>
          </select>
            <select name="keshi" style="position:absolute;left:290px;top:0;width:227px;">
            <option value="">周天虎 1301 A床</option>
			<option value="">周天虎 1301 A床</option>
			<option value="">周天虎 1301 A床</option>
            <option value="">周天虎 1301 A床</option>
            <option value="">周天虎 1301 A床</option>
          </select>
          <span style="position:absolute;left:520px;top:0;"><input type="button" value="确定" class="button_s button1" onclick="" style="height:36px;" /></span>
      </li>
      </ul>

<div style="clear:both;"></div>
<h3>长者：</h3>
     <ul>
         <li style="width:70px;"><span>周天虎</span></li>
         <li><span>国际老人大楼13楼1302室A床</span></li>
     </ul>
<div style="clear:both;"></div>
<h3>VIP卡入院户型</h3>
     <ul><!--VIP卡-->
         <li><span class="tit" style="width:70px;"></span></li>
         <li style="width:150px;"><span>持卡人：周天虎</span></li>
         <li><span>卡ID：2017031313333</span></li>
         <li><span>卡名：A卡</span></li>
         <li><span>二室一厅A户型A床位包间</span></li>
         <li><span>10000元/年</span></li>
         <li><span>12个月</span></li>
         <li><span>可扣24次</span></li>
         <li><span>600元/天</span></li>
     </ul>
     <ul>
         <li><span class="tit" style="width:70px;"></span></li>
         <li><span>饭卡补助6000元</span></li>
         <li><span>半个月扣费</span></li>
         <li><span>保床折扣80%</span></li>
     </ul>

      <ul>
	    <li><span class="tit" style="width:70px;"></span></li>
	    <li style="color:#ff0000;"><span style="margin-right:20px;">剩余时间：</span><span style="margin-right:10px;">6个月</span><span style="margin-right:10px;">可扣12次</span><span style="margin-right:10px;">6个月</span></li>
     </ul>
      <ul>
	    <li><span class="tit" style="width:70px;"></span></li>
	    <li><span style="margin-right:20px;">关系：</span><span style="margin-right:10px;">父子</span></li>
     </ul>
     <!--VIP卡-->
<div style="clear:both;"></div>
<h3>普通入院户型</h3>
     <ul><!--普通人选择户型结果-->
         <li><span class="tit" style="width:70px;"></span></li>
         <li style="width:250px;"><span>二室一厅A户型A床位包间</span></li>
         <li><span>1950元/月</span></li>
         <li><span>950元/天</span></li>
         <li><span>饭卡补助600元</span></li>
         <li><span>半个月扣费975元</span></li>
         <li><span>保床折扣80%</span></li>
     </ul>
     <!--普通人选择户型结果-->
<div style="clear:both;"></div>
<h3>床位详细信息</h3>
     <ul>
        <li><span class="tit" style="width:70px;"></span></li>
        <li><span>国际老人活动大楼</span></li>
        <li><span>13楼</span></li>
        <li><span>1305二室一厅</span></li>
        <li><span>A床</span></li>
     </ul>

<div style="clear:both;"></div>
<h3>服务费用</h3>

     <ul>
        <li><span class="tit" style="width:70px;">选择护理：</span></li>
        <li><span>I级/1900元/月/1个月扣费</span></li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;">基础服务：</span></li>
        <li><span>I级/1900元/月/1个月扣费</span></li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;">护理员：</span></li>
        <li><span>周天虎（长者回院后，请用派单管理进行重新派单）</span></li>
     </ul>

<div style="clear:both;"></div>
<h3>户型变更</h3>
          <ul>
       <li style="width:100%"><span　class="tit" style="width:70px;">户型选择：</span></li>
       <li style="width:100%">
          <span style="display:block;position:absolute;top:5px;left:0;"><input class="magic-radio" type="radio" name="cwlx" id="cwlx1" /><label for="cwlx1" class="label_txt" style="width:80px;">VIP卡</label></span>
          <span><input type="text" placeholder="请输入持卡者姓名或身份证" style="width:215px;position:absolute;top:0;left:90px;"/></span><span style="position:absolute;left:320px;top:0;"><input type="button" value="查找" class="button_s button1" onclick="" style="height:36px;" /></span>
       </li>
       <li style="width:100%">
          <span style="display:block;position:absolute;top:5px;left:0;"><input class="magic-radio" type="radio" name="cwlx" id="cwlx2" /><label for="cwlx2" class="label_txt" style="width:80px;">普通</label></span>
            <select name="keshi" style="position:absolute;left:90px;top:0;width:227px;">
            <option value="二室一厅A户型B床位单床">二室一厅A户型B床位单床</option>
			<option value="二室一厅A户型B床位单床">二室一厅A户型B床位单床</option>
			<option value="二室一厅A户型B床位单床">二室一厅A户型B床位单床</option>
          </select>
          <span style="position:absolute;left:320px;top:0;"><input type="button" value="确定" class="button_s button1" onclick="" style="height:36px;" /></span>
      </li>
    </ul>

     <ul><!--VIP卡查询结果-->
         <li><span class="tit" style="width:70px;"></span></li>
         <li style="width:150px;"><span style="display:block;position:absolute;top:12px;left:0;"><input class="magic-radio" type="radio" name="vipcd" id="vipcd1" /><label for="vipcd1" class="label_txt" style="width:100px;">持卡人：周天虎</label></span></li>
         <li><span>卡ID：2017031313333</span></li>
         <li><span>卡名：A卡</span></li>
         <li><span>二室一厅A户型A床位包间</span></li>
         <li><span>10000元/年</span></li>
         <li><span>12个月</span></li>
         <li><span>可扣24次</span></li>
         <li><span>600元/天</span></li>
     </ul>
     <ul>
         <li><span class="tit" style="width:70px;"></span></li>
         <li><span>饭卡补助6000元</span></li>
         <li><span>半个月扣费</span></li>
         <li><span>保床折扣80%</span></li>
         <li><span style="color:#FF0000;">使用状态：未使用/已经用完/使用中</span></li>
         <li><span style="color:#FF0000;">缴费状态：正在办理/已经缴费/已提供发票</span></li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;"></span></li>
        <li><span style="margin-right:20px;">使用记录：</span><span style="margin-right:10px;">周天虎</span><span style="margin-right:10px;">身份证号：440101197005065113</span><span style="margin-right:10px;">使用6个月</span><span style="margin-right:10px;">扣次12次</span><span style="margin-right:10px;">保留床位5天</span><span style="margin-right:10px;">600元已返至钱包</span></li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;"></span></li>
        <li><span style="margin-right:20px;">出租记录：</span><span style="margin-right:10px;">周天虎</span><span style="margin-right:10px;">身份证号：440101197005065113</span><span style="margin-right:10px;">出租6个月</span><span style="margin-right:10px;">2016-10-5</span></li>
     </ul>
      <ul>
	    <li><span class="tit" style="width:70px;"></span></li>
	    <li style="color:#ff0000;"><span style="margin-right:20px;">剩余时间：</span><span style="margin-right:10px;">6个月</span><span style="margin-right:10px;">可扣12次</span><span style="margin-right:10px;">6个月</span></li>
     </ul>
     <!--VIP卡查询结果-->
     <ul><!--VIP卡查询结果-->
         <li><span class="tit" style="width:70px;"></span></li>
         <li style="width:150px;"><span style="display:block;position:absolute;top:12px;left:0;"><input class="magic-radio" type="radio" name="vipcd" id="vipcd2" /><label for="vipcd2" class="label_txt" style="width:100px;">持卡人：周天虎</label></span></li>
         <li><span>卡ID：2017031313333</span></li>
         <li><span>卡名：A卡</span></li>
         <li><span>二室一厅A户型A床位包间</span></li>
         <li><span>10000元/年</span></li>
         <li><span>12个月</span></li>
         <li><span>可扣24次</span></li>
         <li><span>600元/天</span></li>
     </ul>
     <ul>
         <li><span class="tit" style="width:70px;"></span></li>
         <li><span>饭卡补助6000元</span></li>
         <li><span>半个月扣费</span></li>
         <li><span>保床折扣80%</span></li>
         <li><span style="color:#FF0000;">使用状态：未使用/已经用完/使用中</span></li>
         <li><span style="color:#FF0000;">缴费状态：正在办理/已经缴费/已提供发票</span></li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;"></span></li>
        <li><span style="margin-right:20px;">使用记录：</span><span style="margin-right:10px;">周天虎</span><span style="margin-right:10px;">身份证号：440101197005065113</span><span style="margin-right:10px;">使用6个月</span><span style="margin-right:10px;">扣次12次</span><span style="margin-right:10px;">保留床位5天</span><span style="margin-right:10px;">600元已返至钱包</span></li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;"></span></li>
        <li><span style="margin-right:20px;">出租记录：</span><span style="margin-right:10px;">周天虎</span><span style="margin-right:10px;">身份证号：440101197005065113</span><span style="margin-right:10px;">出租6个月</span><span style="margin-right:10px;">2016-10-5</span></li>
     </ul>
      <ul>
	         <li><span class="tit" style="width:70px;"></span></li>
	         <li style="color:#ff0000;"><span style="margin-right:20px;">剩余时间：</span><span style="margin-right:10px;">6个月</span><span style="margin-right:10px;">可扣12次</span><span style="margin-right:10px;">6个月</span></li>
     </ul>
     <!--VIP卡查询结果-->

     <ul>
        <li><span class="tit" style="width:70px;">关系：</span></li>
        <li style="line-height:36px;"><span><input type="text" placeholder="请输入与持卡人的关系" style="width:220px;position:absolute;top:0;left:0;"/></span><span style="position:absolute;left:235px;top:0;"><input type="button" value="查询" class="button_s button1" onclick="" style="height:36px;" /></span></li>
     </ul>

     <ul><!--普通人选择户型结果-->
         <li><span class="tit" style="width:70px;"></span></li>
         <li style="width:250px;"><span style="display:block;position:absolute;top:12px;left:0;"><input class="magic-checkbox" type="checkbox" name="huxing" id="huxing1" /><label for="huxing1" class="label_txt" style="color:#009688">二室一厅A户型A床位包间</label></span></li>
         <li><span>1950元/月</span></li>
         <li><span>950元/天</span></li>
         <li><span>饭卡补助600元</span></li>
         <li><span>半个月扣费975元</span></li>
         <li><span>保床折扣80%</span></li>
     </ul>
     <!--普通人选择户型结果-->
<div style="clear:both;"></div>
<h3>床位变更</h3>
     <ul>
        <li><span class="tit" style="width:70px;">选择楼房：</span></li>
        <li>
          <select name="loufang" style="width:312px;">
            <option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
			<option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
			<option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
            <option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
            <option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
			<option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
			<option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
            <option value="二室一厅A户型A床位包间">国际老人活动大楼短照中心</option>
          </select>
        </li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;">选择楼层：</span></li>
        <li>
          <select name="loucheng" style="width:312px;">
            <option value="二室一厅A户型A床位包间">1楼</option>
			<option value="二室一厅A户型A床位包间">2楼</option>
			<option value="二室一厅A户型A床位包间">3楼</option>
            <option value="二室一厅A户型A床位包间">4楼</option>
            <option value="二室一厅A户型A床位包间">5楼</option>
			<option value="二室一厅A户型A床位包间">6楼</option>
			<option value="二室一厅A户型A床位包间">7楼</option>
            <option value="二室一厅A户型A床位包间">8楼</option>
          </select>
        </li>
     </ul>


<div style="clear:both;"></div>

     <ul>
       <li style="width:100%;display:inine;position:relative;">
       <span style="display:inline;float:left;width:150px;height:28px;line-height:28px;">1301一室一厅：</span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="11" /><label for="11" class="label_txt" style="width:100px;">1床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="12" disabled/><label for="12" class="label_txt" style="width:100px;">2床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="13" disabled/><label for="13" class="label_txt" style="width:100px;">3床<span style="color:#ff0000">(满)</span></label></span>
       </li>
     </ul>

     <ul>
       <li style="width:100%;display:inine;position:relative;">
       <span style="display:inline;float:left;width:150px;height:28px;line-height:28px;">1301一室一厅：</span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="21" /><label for="21" class="label_txt" style="width:100px;">4床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="22" disabled/><label for="22" class="label_txt" style="width:100px;">5床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="23" /><label for="23" class="label_txt" style="width:100px;">6床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="24" /><label for="24" class="label_txt" style="width:100px;">7床<span style="color:#0000ff">(空)</span></label></span>
       </li>
     </ul>


     <ul>
       <li style="width:100%;display:inine;position:relative;">
       <span style="display:inline;float:left;width:150px;height:28px;line-height:28px;">1301单间：</span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="31" disabled/><label for="31" class="label_txt" style="width:100px;">8床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="32" /><label for="32" class="label_txt" style="width:100px;">9床<span style="color:#0000ff">(空)</span></label></span>
       </li>
     </ul>

     <ul>
       <li style="width:100%;display:inine;position:relative;">
       <span style="display:inline;float:left;width:150px;height:28px;line-height:28px;">1301一室一厅：</span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="41" /><label for="41" class="label_txt" style="width:100px;">10床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="42" /><label for="42" class="label_txt" style="width:100px;">11床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="43" disabled/><label for="43" class="label_txt" style="width:100px;">12床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="44" disabled/><label for="44" class="label_txt" style="width:100px;">13床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="45" /><label for="45" class="label_txt" style="width:100px;">14床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="46" /><label for="46" class="label_txt" style="width:100px;">15床<span style="color:#0000ff">(空)</span></label></span>
       </li>
     </ul>

     <ul>
       <li style="width:100%;display:inine;position:relative;">
       <span style="display:inline;float:left;width:150px;height:28px;line-height:28px;">1301一室一厅：</span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="51" /><label for="51" class="label_txt" style="width:100px;">16床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="52" disabled /><label for="52" class="label_txt" style="width:100px;">17床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="53" disabled/><label for="53" class="label_txt" style="width:100px;">18床<span style="color:#ff0000">(满)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="54" /><label for="54" class="label_txt" style="width:100px;">19床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="55" /><label for="55" class="label_txt" style="width:100px;">20床<span style="color:#0000ff">(空)</span></label></span>
       <span style="display:inline;float:left;"><input class="magic-radio" type="radio" name="bed" id="56" /><label for="56" class="label_txt" style="width:100px;">21床<span style="color:#0000ff">(空)</span></label></span>
       </li>
     </ul>
<div style="clear:both;"></div>
<h3>服务费用变更</h3>

     <ul>
        <li><span class="tit" style="width:70px;">选择护理：</span></li>
        <li>
          <select name="loucheng" style="width:312px;">
            <option value="I级/1900元/月/1个月扣费">I级/1900元/月/1个月扣费</option>
			<option value="II级/1800元/月/半个月扣费">II级/1800元/月/半个月扣费</option>
			<option value="III级/900元/月/1个月扣费">III级/900元/月/1个月扣费</option>
            <option value="I级/1900元/月/1个月扣费">I级/1900元/月/1个月扣费</option>
			<option value="II级/1800元/月/半个月扣费">II级/1800元/月/半个月扣费</option>
			<option value="III级/900元/月/1个月扣费">III级/900元/月/1个月扣费</option>
          </select>
        </li>
     </ul>
     <ul>
        <li><span class="tit" style="width:70px;">基础服务：</span></li>
        <li>
          <select name="loucheng" style="width:312px;">
            <option value="I级/1900元/月/1个月扣费">I级/1900元/月/1个月扣费</option>
			<option value="II级/1800元/月/半个月扣费">II级/1800元/月/半个月扣费</option>
			<option value="III级/900元/月/1个月扣费">III级/900元/月/1个月扣费</option>
            <option value="I级/1900元/月/1个月扣费">I级/1900元/月/1个月扣费</option>
			<option value="II级/1800元/月/半个月扣费">II级/1800元/月/半个月扣费</option>
			<option value="III级/900元/月/1个月扣费">III级/900元/月/1个月扣费</option>
          </select>
        </li>
     </ul>
     <div class="for_ie_div"><!--为兼容IE-->
     <ul>
        <li><input type="button" value="确认提交" class="button button1" onclick="window.open('0zhuyang.html','2-2-1cheping')" style="height:38px;"/></li>
     </ul>
     </div>


  </form>
</div>

<div style="clear:both;"></div>


</body>
</html>